Have you ever wished that you could rub a painkiller into your skin instead of taking so many blasted pills? If only topical painkillers — ointments or creams that contain pain medication — were a real thing.

Well, they’re starting to be. I’ve recently come into possession of two different kinds, both of them prescriptions. It occurs to me that this presents a unique opportunity. Why not try them both at once and see which works better?

I have constant pain under my shoulder blades, and they’re bothering me quite a bit right now, so I’ve applied one topical painkiller to one side, and the other to the other side.

Let’s meet our contestants!

Pennsaid

First up is an ointment called Pennsaid. As I understand it, it’s very new to the market, only recently having been approved by the FDA.

Normally this stuff is obscenely expensive, but my rheumatologist has a deal worked out with a North Carolina pharmacy where either they’ll get your insurance to cover most of it, or they’ll simply charge you $10 for a bottle if your insurance won’t play ball. My case fell into the latter category.

So for ten bucks, I got a 3.8oz (112 gram) bottle with a pump dispenser on top. The active ingredient in Pennsaid is “Diclofenac sodium.” I don’t know about the sodium part, but I know that Diclofenac (in pill form) is commonly prescribed to reduce inflammation.

Pennsaid has an appearance and consistency very similar to baby oil. It’s a clear, runny fluid — thicker than water but much thinner than cream. The instructions that came with the bottle — which were extensive — state that you should pump it twice and then rub it in well to whatever effected area you’re applying it to. Then wash your hands thoroughly after.

Disclaimer: The Pennsaid bottle and instructions say that it is intended for knee pain, and not recommended for other uses. My rheumatologist assured me that, like many other drugs on the market, that is a legal requirement to protect the company that makes it (Horizon Pharma USA, Inc.) and that the ointment can be used for other purposes. He did suggest not applying it anywhere on my head! Not that I was going to.

It does not say how long it will be before you feel the effects, nor how long the effects can be expected to last.

Lidocaine Ointment

This one is a generic, and I don’t know what the brand name version is. To be honest, I’m still a little fuzzy on how I got my hands on it or who helped me get it. I clicked on ad on Facebook that talked about pain management for chronic pain sufferers, filled out a little information — I thought it was for a research study — and then one day I got a phone call about it. I thought they were trying to sell me something, but I dutifully answered their questions. Next thing I know, I’m getting notifications that an order has been placed at a pharmacy I’ve never heard of, my insurance is covering this one (presumably because it’s a generic), and I can expect a package in the next day or two.

And so I received a surprisingly heavy little box that contained not one but two bottles (seen at the top of this page). Or well, a bottle and a jar. This topical painkiller is applied in two parts, apparently. I know this not because there were detailed instructions that came in the package (there weren’t), but because there are “Step 1” and “Step 2” stickers applied to the lids.

The first step is another pump bottle, this one labeled “5% Baclofen” and “5% Diclofenac.” (Hey, that sounds familiar.) This stuff is a white cream, very much like the kind of lotion you’d put on dry skin. Dispense a specific amount of it, rub it in, and wash your hands.

Step 2 is the jar, which is large enough that it could almost be called a tub. Inside is something similar in appearance and consistency to petroleum jelly. This container is labeled “Lidocaine 5% ointment.” You’ve probably heard of Lidocaine; it’s what dentists typically use to numb your gums before working on your teeth. Grab a little of it, slather it over the same spot where you rubbed in the first stuff, and (you guessed it) wash your hands.

Similar to Pennsaid, no details are provided about when it will take effect or how long those effects will last.

And the Winner Is…

Rather unexpectedly, I seem to be getting better results from Pennsaid. I didn’t see that coming, because both medications have Diclofenac (the inflammation reducer), but the Lidocaine ointment comes with two other painkillers as well. Strange that the one that’s only got Diclofenac produced the superior results.

I should point out that this exercise was hardly scientific. It’s very possible that the pain under one shoulder blade was less than the other before any ointments were applied. It’s also possible that I may have used more or less than the proper amounts of the various ointments.

On the whole, I’m encouraged and excited that powerful, prescription topical painkillers are finally becoming a thing. Products like BenGay and Aspercreme are great and all, but they don’t usually produce sufficient results to make using them regularly worthwhile.

That said, in all honesty, I think I’ve gotten more beneficial results from BioFreeze. But admittedly, I probably haven’t used either of these prescription ointments enough yet to know their full potential.

A flare is one of the hardest things to describe about having Lupus. As a writer, that’s a maddening thing. A large part of what I do is finding just the right words to describe something. Feeling these crazy sensations and not being able to convey what that’s like… It does not compute.

One reason it’s hard to describe is because, in my experience, no two flares are ever the same. The first one I ever had caused my hands and feet to swell until it felt like they were going to explode. I’ve never had that sensation again. My usual flares present as red rashes on my arms and legs, along with extra fatigue, muscle pain, and brainfog. I’m having one right now, which is mostly those last three things, but in excessive amounts.

So, I turn to my old frenemy, Prednisone. Or as Lupus patients like to think of it…

…”Satan’s Tic-Tacs.”

I’m fortunate in that my doctor allows me to regulate my Prednisone use myself. I have a standing prescription to always keep some on-hand, so that when a flare strikes, I’m ready. But I still hate taking it.

Yes, Prednisone is horrible. Yes, it’s also helpful. It typically gets rid of my symptoms, but it also makes me feel like this:

And also this:

And usually this:

The weird thing about this particular flare is that none of those things are happening. And my symptoms aren’t really subsiding. This is a first. Does it mean the flare is stronger than a high dose of Prednisone? Yikes, what a thought.

But there’s more. In my book there’s a chapter called “Prepare for Weirdness,” where I talk about odd, inexplicable symptoms. This flare has given me a new one: Nothing tastes good. I get hungry, I want to eat, but everything tastes like cardboard.

Explain that.

This one is also doing its best to bring Depression back into the game. Depression is usually kept in check by my meds, but it’s just a power struggle in the end. If the flare is stronger than the anti-depressants, guess who wins?

And without over-sharing… Let’s just say that stomach issues are becoming a big problem as well.

But like I said at the beginning, there’s other stuff going on inside, strange feelings I don’t know how to describe. I’m not talking about emotions. This is physical stuff. Stuff that just feels… off. A kind of pain, maybe, or a weird imbalance of how things are supposed to be. It’s like the default factory settings have been tampered with, and now nothing is working the way it should.

I wish I could explain a Lupus flare to someone who’s never had one. I’ll keep trying.

I’ve written and published my first-ever nonfiction title, and it’s all about invisible illnesses. You may not know this, but I live with not one but three invisible, chronic illnesses — Lupus, Fibromyalgia, and Postural Orthostatic Tachycardia Syndrome (POTS). I’ve learned a lot over the years and there are loads of things I wish someone had told me from the start. Things that make managing my health and daily life considerably easier.

Enter The Invisible Illness Survival Guide. In it, I share my own story of living with invisible illnesses and provide practical tips and answers to the elephant-in-the-room questions that doctors never tell you.

There’s so much you should have a grasp on as someone diagnosed with an invisible illness. So where’s the handbook that explains all that you need to know?

If you’ve been diagnosed with one of these or the countless other invisible illnesses there are, there’s a lot you need to know. So where’s the handbook?

In this pocket-sized guide, novelist Robin Parrish makes his nonfiction debut with his own story of living with not one but three invisible, chronic illnesses, and the practical things he wishes he’d known from the start—things that will make managing your health and day-to-day life much easier.

Navigating this strange new world can be confusing and overwhelming. The Invisible Illness Survival Guide answers your most difficult, elephant-in-the-room questions—including the ones your doctor never talks about. Questions like:

Did I do something to cause my disease? Am I making it worse?

Can I get my old life back, despite my limitations?

How do I get others to truly understand what I’m going through?

Who’s in control of my healthcare?

How do I find the right doctor for me? And how do I avoid the bad ones?

Can I really trust the modern healthcare system?

Is it normal to constantly have bizarre, new symptoms?

Why does taking my meds make me feel worse, and is there a way around that?

and many more…

The answers to these questions may surprise you. But whatever invisible illness you’re facing, you can still have a full, happy life.